A Step Beyond Convention: Three-Stage Revision with Limb Reconstruction System Fixator for Chronic Infected Total Knee Arthroplasty – A Case Report

Introduction: Chronic periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a limb-threatening complication, especially in the presence of sinus tract formation, bone loss, and failed prior revisions. While two-stage revision remains the standard of care, its success is limited in complex infections. Case Report: We present a single case of chronic infected TKA with a discharging sinus managed successfully using a three-stage revision protocol. The treatment involved implant removal and antibiotic-loaded cement spacer insertion, interim stabilization using a Limb Reconstruction System (LRS) external fixator, and definitive revision TKA. Conclusion: The three-stage revision strategy with interim LRS fixation achieved complete infection eradication, restoration of limb alignment, and satisfactory functional outcome. This approach represents a reliable salvage option in complex chronic PJI cases.